Neobook — clinical reference

- All children with confirmed HIV infection must be staged at diagnosis and as part of regular follow-up
- Children are staged in order to monitor their progress on ART
- If in doubt, discuss the child with a colleague or refer

Stage 1

No symptoms
Persistent generalised lymphadenopathy

Stage 2

Unexplained persistent enlarged liver and/or spleen
Papular pruritic eruptions
Seborrheic dermatitis
Extensive human papilloma infection
Extensive molluscum contagiosum
Fungal nail infections
Recurrent oral ulcerations
Linear gingival erythema
Angular cheilitis
Unexplained persistent enlarged parotid
Herpes zoster
Recurrent or chronic respiratory tract infections (sinusitis, ear infection, otorrhoea, tonsillitis)

Stage 3

Unexplained Moderate Malnutrition not adequately responding to standard therapy
Oral thrush (outside neonatal period)
Oral hairy leucoplakia
Acute necrotising ulcerative gingivitis/periodontitis
The following conditions if unexplained and if not responding to standard treatment:
- Diarrhoea for 14 days or more
- Fever for one month or more
- Anaemia (Hb <8 g/dL) for one month or more
- Neutropaenia (< 500/mm3) for one month
- Thrombocytopaenia (platelets <50,000/mm3) for one month or more
Recurrent severe bacterial pneumonia
Pulmonary TB
TB lymphadenopathy
Chronic HIV-associated lung disease, including bronchiectasis
Symptomatic Lymphoid Interstitial Pneumonitis

Stage 4

Unexplained severe wasting or Severe Malnutrition not adequately responding to standard therapy
Oesophageal thrush
Herpes simplex ulceration for one month or more
Severe multiple or recurrent bacterial infections, two or more episodes in a year (not including pneumonia)
Pneumocystis pneumonia (PCP/ PJP)
Kaposi sarcoma
Extrapulmonary TB

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Integrated Management of Childhood Illness 2022; Anti-Retroviral Therapy; Adapted WHO Clinical Staging

Last checked for updates: June 2023